Association between serum homocysteine, folate and B12 concentration with coronary artery disease in Thai patients

Background: Hyperhomocysteinemia, associated with low folate and low B12 levels, is known to be an independent risk factor for atherosclerosis. Only a few available data has been demonstrated in Thai patients. Objective: To evaluate serum fasting homocysteine, folate and B12 levels whether to see they are associated with coronary artery disease (CAD). Method and Result: Three hundred and one consecutive suspected CAD patients who underwent coronary angiography at the Police General Hospital were studied The mean age of the patients, 195 males and 106 females, was 63.0 ± 10.0 year (range 39-85). A total of 218 patients were angiographically demonstrated as having CAD. The mean serum homocysteine level of CAD patients had a had a non significant higher level than those of 83 non CAD patients: 11.4 ± 6.2 vs 10.2 ± 4.2 umol/L, p = 0.06. Means of folate and B12 level in the CAD patients and non CAD patients were 6.6 ± 4.6 vs 7.0 ± 4.3 nmol/L, p = 0.49 and 650.9 ± 415.4 vs 613.3 ± 443.2 pmol/L, p = 0.56 respectively. No significant correlations were found between homocysteine with folate and B12 levels. Logistic regression analysis showed a significant association between homocysteine and CAD with OR = 1.08 (95% Cl, 1.01-1.16), p = 0.03 after being adjusted for age, sex, DM, HT, history of hyperlipidemia, smoking, BMI, folate and B12 levels. No significant association between homocysteine level with the number of coronary vessel stenosis, age, BMI, DM, HT, smoking and history of hyperlipidemia was observed in the present study. Conclusion: Hyperhomocyteinemia, but not folate and B12 levels, may be an independent risk factor for coronary artery disease in Thai patients.